Eosinophilic gastritis

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Eosinophilic gastritis
Diagnosis in short

Stomach with eosinophilia. H&E stain.

LM abundant eosinophils (>=127 eosinophils/mm2)
LM DDx chronic gastritis, Helicobacter gastritis, Crohn's disease - see inflammatory bowel disease and the stomach, eosinophilic myeloproliferative neoplasm, eosinophilic gastroenteritis
Site stomach

Symptoms +/-abdominal pain
Prevalence very rare
Prognosis benign?
Clin. DDx other causes of gastritis

Eosinophilic gastritis, abbreviated EG, is an uncommon inflammatory process of stomach characterized by abundant eosinophils.

General

  • Rare.

Clinical:

  • Abdominal pain.[1]
  • May mimic a gastric tumour.[2]

Gross

DDx:

Microscopic

Features:

  • Abundant eosinophils -- >=127 eosinophils/mm2.[3]
    • 30 eosinophils/HPF, if the field diameter of 1 HPF is 0.55 mm.

Notes:

  • Normal range:[3]
    • <38 eosinophils/mm2.
      • Typically ~16 eosinophils/mm2.
  • Mild eosinophilia is seen in:[3]

DDx:

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Focal eosinophilia

STOMACH, BIOPSY:
- BODY AND ANTRAL-TYPE GASTRIC MUCOSA WITH MODERATE CHRONIC ACTIVE INFLAMMATION AND
  FOCAL EOSINOPHILIA.
- NEGATIVE FOR HELICOBACTOR-LIKE ORGANISMS.
- NEGATIVE FOR INTESTINAL METAPLASIA.
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY.

COMMENT:
One of four tissue fragments has eosinophilia, with 45 eosinophils/1 HPF (where 1 HPF 
is 0.2376 mm*mm).

See also

References

  1. Ayyub, M.; Almenawi, L.; Mogharbel, MH.. "Eosinophilic gastritis; an unusual and overlooked cause of chronic abdominal pain.". J Ayub Med Coll Abbottabad 19 (4): 127-30. PMID 18693615.
  2. Holroyd, DJ.; Banerjee, S.; Chaudhary, KS.; Reshamwalla, S.; Vijay, V.; Ward, MW. (May 2010). "Transmural eosinophilic gastritis with gastric outlet obstruction: case report and review of the literature.". Ann R Coll Surg Engl 92 (4): W18-20. doi:10.1308/147870810X12659688851915. PMID 20501003.
  3. 3.0 3.1 3.2 Lwin, T.; Melton, SD.; Genta, RM. (Apr 2011). "Eosinophilic gastritis: histopathological characterization and quantification of the normal gastric eosinophil content.". Mod Pathol 24 (4): 556-63. doi:10.1038/modpathol.2010.221. PMID 21169993.